A blog that takes the reader through the principles of Lean Management and Six Sigma in a practical way. The ultimate goal is to help the medical practice to meet its goal of becoming more efficient in providing care and meeting the patients needs. | Contact Owen Dahl at 832-260-4455 or at his website OwenDahlConsulting.com

Friday, August 7, 2015

Medical Practice Question: To Charge, or Not to Charge for No-shows

A question that I am often asked is whether or not there should be charge for no-shows. In most cases this creates bad vibes with patients and creates a lot of work on the back end with little results. A blanket response to a provider complaining at a board meeting about the fact that there are a lot of no-shows is not appropriate.

What is your percentage of no-shows per week? I am not aware of a good benchmark but in talking with practices, the goal of less than 3% seems reasonable.

Instead the root cause of no-shows should be considered. Here are a few questions that should be asked when the issue of no shows comes up:

Is it one provider?

Is it one day of the week or time of that day?

Is it one payer type?

Is it one age group?

Is it new patients?

How long from the call to the appointment?

Is it established patients?

Repeat offenders that can and should be dealt with individually?

Others in your practice?

The main point of this is that the administrator should have sufficient data in place to offer a well thought out plan. A blanket response implies unawareness, laziness, or reactionary decision making. This type of action often times causes more problems than offers solutions.

This does not mean that a no-show charge is not warranted, it may well be for certain patients, e.g., a behavioral health patient that has difficulty with responsibility may learn something from having to pay for that a mistake.

We may have done such a good job training our patients that we always run late that they can come in late or maybe not bother to show up since they are feeling better.

We may have a provider that needs help with bed side manner and efficiency.

We may have a scheduling issue and schema and protocols needs to be changed as a result of the analysis of data.

I am sure you can find many more reasons, come up with solid solutions and develop a well thought out transition plan to address those solutions!

No comments:

Post a Comment

Follow Owen Dahl by Email

About Me

Owen J. Dahl, MBA, FACHE, LSSMBB, has been active in healthcare management for almost 40 years. He received his bachelor’s degree from Concordia College, Moorhead, Minnesota, where he was a member of the first graduating class in the hospital administration program. He then spent more than a decade as a hospital administrator in various facilities in South Dakota. He also served in the United States Air Force.

His move to New Orleans in 1983 brought a major career change. He started a practice management and billing company, which grew to manage 65 physicians in 11 different practices with revenues well over $75 million. In 1993, he advanced to Fellow in the American College of Healthcare Executives with a paper on Total Quality Management and its application to the medical practice. He also received the distinction of becoming the first non-physician member of the Orleans Parish Medical Services Bureau Board of Directors.

Throughout his career, Owen has maintained a passion for education. He developed an adult continuing education program with Loyola University of New Orleans in physician practice management. He also is the original developer of the certification program for the Professional Association of Health Care Office Managers (PAHCOM) and the Institute of Certified Healthcare Business Consultants (ICHBC). The Institute program is currently available online through the National Society of Certified Healthcare Business Consultants (NSCHBC). He has worked with the Louisiana State University Medical School Department of Graduate Medical Education conducting seminars for students, residents, and fellows in physician practice management.